Transurethral needle ablation device with cystoscope and method for treatment of the prostate

In a method for the treatment of the prostate of a human male having a bladder with a base, a prostate and a penis with a urethra formed by a urethral wall extending from the base of the bladder through the prostate and the penis along a longitudinal axis with the prostate having prostatic tissue surrounding the urethral wall and a capsule enclosing the prostatic tissue by the use of a needle electrode having a distal extremity, the needle electrode being enclosed in an insulation sleeve and the insulation sleeve and the needle electrode being movable with resect to each other comprising the steps of introducing the needle electrode into the urethra and advancing the needle electrode along the longitudinal axis until the needle electrode is in the vicinity of the prostate, thereafter bending the distal extremity of the needle electrode in a direction at an angle to the longitudinal axis of the urethra to face the urethral wall, advancing the distal extremity of the needle electrode to penetrate the urethral wall and to extend into the tissue of the prostate so that a preselected length of the needle electrode is disposed in the tissue of the prostate and the insulation sleeve extends beyond the urethral wall, applying radio frequency energy to the electrode to cause current to flow by conduction in the tissue of the prostate at a sufficient power level and for a sufficient period of time to raise the temperature of the tissue in the prostate in the vicinity of the needle electrode and in a defined area to cause ablation and formation of a lesion in the tissue of the prostate which is spaced from the urethral wall while the urethral wall is protected by the insulation sleeve from the radio frequency energy during the application of radio frequency energy to the needle electrode.

A transurethral needle ablation device for the treatment of the prostate of a human male using radio frequency energy from a radio frequency power source, the human male having a bladder with a base, a prostate and a penis with a urethra therein formed by a urethral wall extending from the base of the bladder through the prostate and the penis along a longitudinal axis with the prostate having prostatic tissue surrounding the urethral wall near the base of the bladder comprising a sheath having proximal and distal extremities and having a lumen extending from the proximal extremity to the distal extremity, a guide tube assembly slidably mounted in the lumen in the sheath and having proximal and distal extremities and having a lumen extending from the proximal extremity to the distal extremity and having a longitudinal axis, a needle electrode slidably mounted in the lumen of the guide tube assembly and having proximal and distal extremities, an insulation sleeve coaxially disposed on the needle electrode, a handle adapted to be gripped by the human hand, means for mounting the proximal extremity of the guide tube assembly on the handle, means for causing bending of the distal extremity of the guide tube assembly at an angle with respect to the longitudinal axis whereby the lumen in the guide tube assembly can be directed so that it faces the urethral wall, means connected to the needle electrode adapted to be coupled to the radio frequency power source for supplying radio frequency energy to the needle electrode, means carried by the handle and coupled to the needle electrode and the insulating sleeve for advancing and retracting the needle electrode with respect to the guide tube whereby when the sheath is positioned in the urethra with its distal extremity in the vicinity of the prostate, the needle electrode can be advanced through the urethral wall and into the tissue of the prostate and the insulating sleeve advanced through the urethral wall while leaving a preselected length of the needle electrode exposed in the tissue of the prostate whereby upon the application of radio frequency energy to the needle electrode tissue of the prostate surrounding the needle electrode is ablated to form a lesion in the tissue of the prostate while the urethral wall is protected from the radio frequency energy the insulating sleeve.

A method for the treatment of benign prostatic hypertrophy of the prostate of the human male having a bladder with a base and a penis with a urethra therein formed by a urethral wall extending into the base of the bladder along a longitudinal axis with the prostate having tissue surrounding the urethra near the base of the bladder by the use of a radiofrequency electrode formed of an electrically conductive material and being relatively rigid so that it can serve as a stylet and having a sharpened distal extremity serving as a tissue puncturing tip comprising the steps of introducing the radio frequency electrode into the urethra and advancing it longitudinally of the urethra along the longitudinal axis until the tip is in the vicinity of the prostate, thereafter advancing the radiofrequency electrode in a direction at an angle to the longitudinal axis of the urethra to cause it to penetrate the urethral wall and to extend into the tissue of the prostate so that a preselected length of the radiofrequency electrode including the tip is exposed to tissue in the prostate to thereby select a target volume of the tissue in the prostate surrounding the exposed length of the radio frequency electrode to be exposed to radio frequency energy, supplying radio frequency energy to the radio frequency electrode so that radio frequency energy is supplied to the selected target volume of the prostate surrounding the exposed length of the radio frequency electrode at a sufficient power level and for a sufficient period of time to raise the temperature of the tissue of the prostate in the selected target volume to cause ablation of the tissue in the selected target volume and thereafter withdrawing the radio frequency electrode from the tissue of the prostate through the urethral wall and out of the urethra.

A method for the treatment of benign prostatic hypotrophy of the prostate of the human male having a bladder with a base and a penis with a urethra therein formed by a urethral wall extending into the base of the bladder along a longitudinal axis with the prostate having tissue surrounding the urethra near the base of the bladder by the use of a radio frequency electrode formed of an electrically conductive material and being relatively rigid so that it can serve as a stylet and having a sharpened distal extremity serving as a tissue puncturing tip and a sleeve of insulating material slidably mounted on the radio frequency electrode movable to expose a preselected length of the radio frequency electrode comprising the steps of selecting a target volume of the tissue of the prostate to be ablated by the use of radio frequency energy, introducing the radio frequency electrode with the sleeve thereon into the urethra and advancing the radio frequency electrode longitudinally of the urethra until the tip is in the vicinity of the prostate, advancing the tip of the radio frequency electrode in a direction at an angle to the longitudinal axis of the urethra to cause the tip of the radio frequency electrode to penetrate the urethral wall and to extend into the target volume of the tissue of the prostate so that the target volume of the tissue of the prostate surrounds the radio frequency electrode, moving the sleeve so that it extends through the urethral wall to expose a preselected length of the radio frequency electrode extending beyond the urethral wall so that radio frequency energy can be supplied to the target volume but not to the urethral wall, supplying radio frequency energy to the radio frequency electrode at a sufficient power level and for a sufficient period of time to cause the temperature of the tissue of the prostate in the target volume to cause ablation of the tissue in the target volume while inhibiting ablation of the urethral wall.

A medical probe for use with the human hand for the treatment by radio frequency ablation of a target volume in the tissue of a prostate of a human male having a bladder with a base and a penis with a urethra therein formed by a urethral wall extending into the base of the bladder along a longitudinal axis with the tissue of the prostate surrounding the urethra near the base of the bladder comprising an elongate member having proximal and distal extremities and having a longitudinal axis and being sized to be able to enter the urethra and having a length so that when the distal extremity is disposed in the vicinity of the prostate the proximal extremity is outside the urethra, said elongate member having a sidewall defining a passageway extending along the longitudinal axis, said distal extremity having an outlet port in communication with the passageway, a radio frequency electrode of an electrically conductive material disposed in said passageway and having a sharpened tip, a sleeve formed of insulating material coaxially mounted on said radio frequency electrode and disposed in said passageway, said sleeve being disposed on said radio frequency electrode so that a preselected length of the radio frequency electrode can extend beyond the sleeve and be exposed to the target volume when the radio frequency electrode has been advanced into the target volume so that tissue of the prostate in the target volume surrounds the preselected length of the radio frequency electrode, and means for supplying radio frequency energy to the radio frequency electrode.

A medical probe for use with the human hand for the treatment by radio frequency ablation of a target volume in the tissue of a prostate of a human male having a bladder with a base and a penis with a urethra therein formed by a urethral wall extending into the base of the bladder along a longitudinal axis with the tissue of the prostate surrounding the urethra near the base of the bladder comprising an elongate member having proximal and distal extremities and having a longitudinal axis and being sized to be able to enter the urethra and having a length so that when the distal extremity is disposed in the vicinity of the prostate the proximal extremity is outside of the urethra, said elongate member having a sidewall defining a passageway extending along the longitudinal axis, said distal extremity having an outlet port in communication with the passageway, a radio frequency electrode of an electrically conductive material disposed in said passageway and having a sharpened tip, a sleeve formed of insulating material coaxially mounted on said radio frequency electrode and disposed in said passageway, said sleeve being disposed on said radio frequency electrode so that a preselected length of the radio frequency electrode can extend beyond the sleeve, a handle secured to the proximal extremity of the elongate member, means for moving said radio frequency electrode and said sleeve when the elongate member is disposed within the urethra out of the outlet port of the elongate member so that the preselected length of the radio frequency electrode is disposed in tissue within the target volume of the prostate and the sleeve extends through the urethral wall and means for supplying radio frequency energy to the radio frequency electrode to cause ablation of tissue in the target volume of the prostate while the urethral wall is protected from the radio frequency energy by the sleeve.